Outline

Objective

Case report of a patient with chiasmal migration of intraocular silicone oil resulting in a visual field defect in the contralateral eye.

Methods

A 66-year-old male patient presented with a hemianopia of sudden onset on the right eye 12 months after vitrectomy for retinal detachment with silicone oil used as an intraocular tamponade in the left eye. Visual acuity was 20/20 in the right and light perception in the left eye. Intraocular pressure was normal in the right and 35 mmHg in the left eye due to emulsified silicone oil in the anterior chamber. Funduscopy revealed a glaucomatous excavation of the left optic disc and an incomplete silicone oil filling of the globe. MRI imaging showed silicone oil located in the left optic nerve and the chiasm.

Results

The patient underwent surgery and via a left subfrontal approach the left optic nerve and the chiasm were slit open and the oil was removed by suction. After internal decompression of the chiasm, an improvement of the visual field in the right eye was noted.

Conclusions

Intraocular silicone oil may migrate along the optic nerve and cause visual field defects in the fellow eye under unknown circumstances. Whether the elevated intraocular pressure might have contributed to this phenomenon remains hypothetical.